title: Local recurrence patterns in breast cancer patients treated with oncoplastic reduction mammaplasty and radiotherapy.
abstract: BACKGROUND
  The purpose of this study was to describe the incidence and location of ipsilateral breast tumor recurrence (IBTR) among breast cancer patients treated with oncoplastic reduction mammoplasty (ORM) and radiotherapy (RT).
  
  
  METHODS
  The medical records of 86 consecutive women with ductal carcinoma in situ (DCIS) (n = 11) or invasive carcinoma of the breast (n = 75) treated with ORM at Emory University between January 1994 and December 2010 were reviewed.
  
  
  RESULTS
  Following ORM, prolonged wound healing or surgical complications led to delay of adjuvant chemotherapy or RT in 11 patients. Surgical clips were found outside the primary tumor breast quadrant in 43 % of the patients with available RT planning CT images. When the clips were found outside the primary tumor quadrant, the RT boost was more frequently delivered outside versus inside the primary tumor quadrant (67 vs. 33 %, p < 0.001). After a median follow-up period of 4.5 years (range 0.1-17.9), 6 patients developed an IBTR and only 1 IBTR occurred outside the primary tumor quadrant. The 5-year ipsilateral breast tumor control rates were 91 % (95 % CI 0.82-0.99) and 93 % (95 % CI 0.90-0.97) for patients with DCIS and invasive carcinoma, respectively.
  
  
  CONCLUSIONS
  The use of ORM yields acceptable rates of IBTR. ORM may displace breast tissue and surgical clips to breast quadrants outside of the original tumor location, but the majority of IBTRs still occur in the original tumor quadrant. This area remains at highest risk of in-breast recurrence in women treated with ORM irrespective of surgical clip location.
authors.affiliation: Department of Radiation Oncology, Emory University, Atlanta, GA, USA, brupper@emory.edu.
authors.forename: Bree R
authors.initials: BR
authors.lastname: Eaton
authors.forename: Albert
authors.initials: A
authors.lastname: Losken
authors.forename: Derick
authors.initials: D
authors.lastname: Okwan-Duodu
authors.forename: David M
authors.initials: DM
authors.lastname: Schuster
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Switchenko
authors.forename: Donna
authors.initials: D
authors.lastname: Mister
authors.forename: Karen
authors.initials: K
authors.lastname: Godette
authors.forename: Mylin A
authors.initials: MA
authors.lastname: Torres
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D018270:Carcinoma, Ductal, Breast / Q000401:mortality / Q000556:secondary / Q000628:therapy*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000401:mortality / Q000556:secondary / Q000628:therapy*; D018275:Carcinoma, Lobular / Q000401:mortality / Q000556:secondary / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D016462:Mammaplasty; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D009367:Neoplasm Staging; D011379:Prognosis; D011878:Radiotherapy; D015996:Survival Rate